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Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

BILLINGS CLINIC BROADWATER

Townsend, MT · CCN 271333 · Rates published

1,497 distinct procedures filed
28 distinct payers
65,499 rate rows
2025-12-11 last MRF observed
Data quality

64,182 of 65,499 rate rows are consumer-grade (98.0%)

1,317 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 975
percent-of-charges filed in the dollar field — excluded from medians 224
per-diem day rate — not a per-procedure price 116
exceeds 10× this hospital's gross charge — excluded from medians 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbBHCTOWNSENDMT&type=CDMWithoutLabel&fileType=CSV
Found on page https://apps.para-hcfs.com/PTT/FinalLinks/BroadWater_V2.aspx
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-14
Content fingerprint 35680cf8ea65e43a… · 30,940,464 bytes · first seen 2026-05-08

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
192
MS_DRG 		Chronic Obstructive Pulmonary Disease Without Cc/mcc 1 $233,496.52 $233,496.52 $233,496.52 nat. median
$5,010
outlier · 46.6×
299
MS_DRG 		Peripheral Vascular Disorders With Mcc 1 $219,578.78 $219,578.78 $219,578.78 nat. median
$11,794
outlier · 18.6×
561
MS_DRG 		Aftercare, Musculoskeletal System And Connective Tissue Without Cc/mcc 1 $192,019.71 $192,019.71 $192,019.71 nat. median
$5,841
outlier · 32.9×
309
MS_DRG 		Cardiac Arrhythmia And Conduction Disorders With Cc 1 $145,489.76 $145,489.76 $145,489.76 nat. median
$5,574
outlier · 26.1×
949
MS_DRG 		Aftercare With Cc/mcc 1 $129,325.45 $129,325.45 $129,325.45 nat. median
$8,367
outlier · 15.5×
372
MS_DRG 		Major Gastrointestinal Disorders And Peritoneal Infections With Cc 1 $129,105.26 $129,105.26 $129,105.26 nat. median
$7,653
outlier · 16.9×
391
MS_DRG 		Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 1 $128,461.20 $128,461.20 $128,461.20 nat. median
$9,511
outlier · 13.5×
593
MS_DRG 		Skin Ulcers With Cc 1 $127,724.78 $127,724.78 $127,724.78 nat. median
$8,571
outlier · 14.9×
694
MS_DRG 		Urinary Stones Without Mcc 1 $99,584.40 $99,584.40 $99,584.40 nat. median
$5,874
outlier · 17.0×
641
MS_DRG 		Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 1 $90,541.00 $90,541.00 $90,541.00 nat. median
$5,850
outlier · 15.5×
948
MS_DRG 		Signs And Symptoms Without Mcc 1 $82,951.01 $82,951.01 $82,951.01 nat. median
$5,562
outlier · 14.9×
683
MS_DRG 		Renal Failure With Cc 1 $82,043.74 $82,043.74 $82,043.74 nat. median
$6,692
outlier · 12.3×
57
MS_DRG 		Degenerative Nervous System Disorders Without Mcc 1 $81,978.27 $81,978.27 $81,978.27 nat. median
$8,924
outlier · 9.2×
557
MS_DRG 		Tendonitis, Myositis And Bursitis With Mcc 1 $81,890.78 $81,890.78 $81,890.78 nat. median
$10,772
outlier · 7.6×
291
MS_DRG 		Heart Failure And Shock With Mcc 1 $74,809.82 $74,809.82 $74,809.82 nat. median
$9,572
outlier · 7.8×
559
MS_DRG 		Aftercare, Musculoskeletal System And Connective Tissue With Mcc 1 $73,950.81 $73,950.81 $73,950.81 nat. median
$13,403
outlier · 5.5×
178
MS_DRG 		Respiratory Infections And Inflammations With Cc 1 $69,705.43 $69,705.43 $69,705.43 nat. median
$7,418
outlier · 9.4×
560
MS_DRG 		Aftercare, Musculoskeletal System And Connective Tissue With Cc 1 $65,427.77 $65,427.77 $65,427.77 nat. median
$8,402
outlier · 7.8×
947
MS_DRG 		Signs And Symptoms With Mcc 1 $63,616.80 $63,616.80 $63,616.80 nat. median
$8,698
outlier · 7.3×
292
MS_DRG 		Heart Failure And Shock With Cc 1 $63,408.33 $63,408.33 $63,408.33 nat. median
$6,415
outlier · 9.9×
841
MS_DRG 		Lymphoma And Non-acute Leukemia With Cc 1 $54,384.74 $54,384.74 $54,384.74 nat. median
$11,732
outlier · 4.6×
194
MS_DRG 		Simple Pneumonia And Pleurisy With Cc 1 $53,364.87 $53,364.87 $53,364.87 nat. median
$6,156
outlier · 8.7×
872
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 1 $51,308.69 $51,308.69 $51,308.69 nat. median
$7,744
outlier · 6.6×
871
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 1 $43,521.33 $43,521.33 $43,521.33 nat. median
$14,442
outlier · 3.0×
66
MS_DRG 		Intracranial Hemorrhage Or Cerebral Infarction Without Cc/mcc 1 $36,205.54 $36,205.54 $36,205.54 nat. median
$5,324
outlier · 6.8×
758
MS_DRG 		Infections, Female Reproductive System With Cc 1 $30,048.20 $30,048.20 $30,048.20 nat. median
$7,191
outlier · 4.2×
439
MS_DRG 		Disorders Of Pancreas Except Malignancy With Cc 1 $18,736.68 $18,736.68 $18,736.68 nat. median
$6,417
outlier · 2.9×
J1459
HCPCS 		Inj Ivig Privigen 500 Mg 28 $13,303.50 $19,005.00 $18,054.75 nat. median
$968
outlier · 18.7×
J2997
HCPCS 		Alteplase Recombinant 28 $9,253.30 $13,219.00 $12,558.05 nat. median
$428
outlier · 29.3×
J9332
HCPCS 		Inj Efgartigimod 2mg 28 $6,886.60 $9,838.00 $9,346.10 nat. median
$84
outlier · 110.6×
56
MS_DRG 		Degenerative Nervous System Disorders With Mcc 1 $9,342.48 $9,342.48 $9,342.48 nat. median
$14,194
0.7× median
690
MS_DRG 		Kidney And Urinary Tract Infections Without Mcc 1 $9,133.34 $9,133.34 $9,133.34 nat. median
$6,107
1.5× median
J3101
HCPCS 		Tenecteplase Injection 28 $6,597.50 $9,425.00 $8,953.75 nat. median
$498
outlier · 18.0×
J1561
HCPCS 		Gamunex-c/gammaked 28 $1,654.10 $18,726.00 $8,907.20 nat. median
$994
outlier · 9.0×
J2506
HCPCS 		Inj Pegfilgrast Ex Bio 0.5mg 28 $5,053.30 $7,219.00 $6,858.05 nat. median
$916
outlier · 7.5×
J0565
HCPCS 		Inj, Bezlotoxumab, 10 Mg 28 $4,968.60 $7,098.00 $6,743.10 nat. median
$121
outlier · 55.9×
81162
HCPCS 		Brca1&2 Gen Full Seq Dup/del 28 $4,532.50 $6,475.00 $6,151.25 nat. median
$1,880
outlier · 3.3×
J0840
HCPCS 		Crotalidae Poly Immune Fab 28 $4,489.10 $6,413.00 $6,092.35 nat. median
$3,496
1.7× median
Q5115
HCPCS 		Inj Truxima 10 Mg 28 $3,614.80 $5,164.00 $4,905.80 nat. median
$368
outlier · 13.3×
J1599
HCPCS 		Ivig Non-lyophilized, Nos 28 $1,678.60 $9,515.00 $4,529.25 nat. median
$281
outlier · 16.1×
8028141_1
CDM 		25 $3,217.50 $4,290.00 $4,161.30 —
8028202_1
CDM 		25 $2,961.75 $3,949.00 $3,830.53 —
8028232_1
CDM 		25 $2,941.50 $3,922.00 $3,804.34 —
A0433
HCPCS 		Als 2 28 $2,569.70 $3,671.00 $3,487.45 nat. median
$783
outlier · 4.5×
8028201_1
CDM 		25 $2,685.75 $3,581.00 $3,473.57 —
90378
HCPCS 		Rsv Mab IM 50mg 28 $2,382.10 $5,020.00 $3,458.50 nat. median
$2,008
1.7× median
8028231_1
CDM 		25 $2,577.00 $3,436.00 $3,332.92 —
8028229_1
CDM 		25 $2,300.25 $3,067.00 $2,974.99 —
J0897
HCPCS 		Denosumab Injection 28 $1,883.00 $2,690.00 $2,555.50 nat. median
$86
outlier · 29.7×
70543
HCPCS 		MRI Orbt/fac/nck Without &with Contrast 28 $1,873.90 $2,677.00 $2,543.15 nat. median
$605
outlier · 4.2×

Other procedures at this hospital

Browse this hospital's 1,497 published procedures. Use the slice to choose what to show, then sort or filter any column.

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Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
192 MS_DRG Chronic Obstructive Pulmonary Disease Without Cc/mcc 1 1 $85,436.52 $85,436.52 $233,496.52 $233,496.52 $233,496.52 2025-12-11
299 MS_DRG Peripheral Vascular Disorders With Mcc 1 1 $83,363.58 $83,363.58 $219,578.78 $219,578.78 $219,578.78 2025-12-11
561 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue Without Cc/mcc 1 1 $67,649.31 $67,649.31 $192,019.71 $192,019.71 $192,019.71 2025-12-11
309 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Cc 1 1 $50,731.36 $50,731.36 $145,489.76 $145,489.76 $145,489.76 2025-12-11
949 MS_DRG Aftercare With Cc/mcc 1 1 $46,411.85 $46,411.85 $129,325.45 $129,325.45 $129,325.45 2025-12-11
372 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Cc 1 1 $46,191.66 $46,191.66 $129,105.26 $129,105.26 $129,105.26 2025-12-11
391 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 1 1 $51,470.00 $51,470.00 $128,461.20 $128,461.20 $128,461.20 2025-12-11
593 MS_DRG Skin Ulcers With Cc 1 1 $44,811.18 $44,811.18 $127,724.78 $127,724.78 $127,724.78 2025-12-11
694 MS_DRG Urinary Stones Without Mcc 1 1 $34,438.00 $34,438.00 $99,584.40 $99,584.40 $99,584.40 2025-12-11
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 1 1 $31,317.00 $31,317.00 $90,541.00 $90,541.00 $90,541.00 2025-12-11
948 MS_DRG Signs And Symptoms Without Mcc 1 1 $29,649.41 $29,649.41 $82,951.01 $82,951.01 $82,951.01 2025-12-11
683 MS_DRG Renal Failure With Cc 1 1 $28,742.14 $28,742.14 $82,043.74 $82,043.74 $82,043.74 2025-12-11
57 MS_DRG Degenerative Nervous System Disorders Without Mcc 1 1 $28,676.67 $28,676.67 $81,978.27 $81,978.27 $81,978.27 2025-12-11
557 MS_DRG Tendonitis, Myositis And Bursitis With Mcc 1 1 $28,589.18 $28,589.18 $81,890.78 $81,890.78 $81,890.78 2025-12-11
291 MS_DRG Heart Failure And Shock With Mcc 1 1 $27,430.62 $27,430.62 $74,809.82 $74,809.82 $74,809.82 2025-12-11
559 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Mcc 1 1 $26,571.61 $26,571.61 $73,950.81 $73,950.81 $73,950.81 2025-12-11
178 MS_DRG Respiratory Infections And Inflammations With Cc 1 1 $28,248.63 $28,248.63 $69,705.43 $69,705.43 $69,705.43 2025-12-11
560 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Cc 1 1 $23,970.97 $23,970.97 $65,427.77 $65,427.77 $65,427.77 2025-12-11
947 MS_DRG Signs And Symptoms With Mcc 1 1 $22,160.00 $22,160.00 $63,616.80 $63,616.80 $63,616.80 2025-12-11
292 MS_DRG Heart Failure And Shock With Cc 1 1 $21,951.53 $21,951.53 $63,408.33 $63,408.33 $63,408.33 2025-12-11
841 MS_DRG Lymphoma And Non-acute Leukemia With Cc 1 1 $18,850.34 $18,850.34 $54,384.74 $54,384.74 $54,384.74 2025-12-11
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 1 1 $23,752.87 $23,752.87 $53,364.87 $53,364.87 $53,364.87 2025-12-11
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 1 1 $21,696.69 $21,696.69 $51,308.69 $51,308.69 $51,308.69 2025-12-11
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 1 1 $19,831.73 $19,831.73 $43,521.33 $43,521.33 $43,521.33 2025-12-11
66 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction Without Cc/mcc 1 1 $12,515.94 $12,515.94 $36,205.54 $36,205.54 $36,205.54 2025-12-11
758 MS_DRG Infections, Female Reproductive System With Cc 1 1 $12,281.00 $12,281.00 $30,048.20 $30,048.20 $30,048.20 2025-12-11
439 MS_DRG Disorders Of Pancreas Except Malignancy With Cc 1 1 $6,891.88 $6,891.88 $18,736.68 $18,736.68 $18,736.68 2025-12-11
J1459 HCPCS Injection, Immune Globulin (privigen), Intravenous, Non-lyophilized (e.g., Liqui… 28 28 $19,005.00 $19,005.00 $13,303.50 $19,005.00 $18,054.75 2025-12-11
J2997 HCPCS Injection, Alteplase Recombinant, 1 Mg 28 28 $13,219.00 $13,219.00 $9,253.30 $13,219.00 $12,558.05 2025-12-11
J9332 HCPCS Injection, Efgartigimod Alfa-fcab, 2mg 28 28 $9,838.00 $9,838.00 $6,886.60 $9,838.00 $9,346.10 2025-12-11
56 MS_DRG Degenerative Nervous System Disorders With Mcc 1 1 $3,420.08 $3,420.08 $9,342.48 $9,342.48 $9,342.48 2025-12-11
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 1 1 $3,210.94 $3,210.94 $9,133.34 $9,133.34 $9,133.34 2025-12-11
J3101 HCPCS Injection, Tenecteplase, 1 Mg 28 28 $9,425.00 $9,425.00 $6,597.50 $9,425.00 $8,953.75 2025-12-11
J1561 HCPCS Injection, Immune Globulin, (gamunex-c/gammaked), Non-lyophilized (e.g., Liquid)… 112 28 $9,321.00 $9,321.00 $1,654.10 $18,726.00 $8,907.20 2025-12-11
J2506 HCPCS Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 28 28 $7,219.00 $7,219.00 $5,053.30 $7,219.00 $6,858.05 2025-12-11
J0565 HCPCS Injection, Bezlotoxumab, 10 Mg 28 28 $7,098.00 $7,098.00 $4,968.60 $7,098.00 $6,743.10 2025-12-11
81162 HCPCS Gene Analysis (breast Cancer 1 And 2) Of Full Sequence And Analysis For Duplicat… 28 28 $6,475.00 $6,475.00 $4,532.50 $6,475.00 $6,151.25 2025-12-11
J0840 HCPCS Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram 28 28 $6,413.00 $6,413.00 $4,489.10 $6,413.00 $6,092.35 2025-12-11
Q5115 HCPCS Injection, Rituximab-abbs, Biosimilar, (truxima), 10 Mg 28 28 $5,164.00 $5,164.00 $3,614.80 $5,164.00 $4,905.80 2025-12-11
J1599 HCPCS Injection, Immune Globulin, Intravenous, Non-lyophilized (e.g., Liquid), Not Oth… 56 28 $5,956.50 $5,956.50 $1,678.60 $9,515.00 $4,529.25 2025-12-11
8028141_1 CDM Coronary Care Unit - General Classification 25 25 $4,290.00 $4,290.00 $3,217.50 $4,290.00 $4,161.30 2025-12-11
8028202_1 CDM Room & Board - Other - Sterile Environment 25 25 $3,949.00 $3,949.00 $2,961.75 $3,949.00 $3,830.53 2025-12-11
8028232_1 CDM Coronary Care Unit - General Classification 25 25 $3,922.00 $3,922.00 $2,941.50 $3,922.00 $3,804.34 2025-12-11
A0433 HCPCS Advanced Life Support, Level 2 (als 2) 28 28 $3,671.00 $3,671.00 $2,569.70 $3,671.00 $3,487.45 2025-12-11
8028201_1 CDM Room & Board - Semi-private (two Beds) - General Classification 25 25 $3,581.00 $3,581.00 $2,685.75 $3,581.00 $3,473.57 2025-12-11
90378 HCPCS Respiratory Syncytial Virus Antibody For Injection Into Tissue Or Muscle 56 28 $4,211.50 $4,211.50 $2,382.10 $5,020.00 $3,458.50 2025-12-11
8028231_1 CDM Room & Board - Other - Sterile Environment 25 25 $3,436.00 $3,436.00 $2,577.00 $3,436.00 $3,332.92 2025-12-11
8028229_1 CDM Room & Board - Other - Other 25 25 $3,067.00 $3,067.00 $2,300.25 $3,067.00 $2,974.99 2025-12-11
J0897 HCPCS Injection, Denosumab, 1 Mg 28 28 $2,690.00 $2,690.00 $1,883.00 $2,690.00 $2,555.50 2025-12-11
70543 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast 28 28 $2,677.00 $2,677.00 $1,873.90 $2,677.00 $2,543.15 2025-12-11
72158 HCPCS MRI Scan Of Lower Spinal Canal Before And After Contrast 56 28 $2,560.00 $2,560.00 $1,792.00 $2,560.00 $2,432.00 2025-12-11
72157 HCPCS MRI Scan Of Middle Spinal Canal Before And After Contrast 56 28 $2,560.00 $2,560.00 $1,792.00 $2,560.00 $2,432.00 2025-12-11
70553 HCPCS MRI Scan Of Brain Before And After Contrast 56 28 $2,560.00 $2,560.00 $1,792.00 $2,560.00 $2,432.00 2025-12-11
72156 HCPCS MRI Scan Of Upper Spinal Canal Before And After Contrast 56 28 $2,560.00 $2,560.00 $1,792.00 $2,560.00 $2,432.00 2025-12-11
72197 HCPCS MRI Scan Of Pelvis Before And After Contrast 56 28 $2,558.00 $2,558.00 $1,790.60 $2,558.00 $2,430.10 2025-12-11
74177 HCPCS CT Scan Of Abdomen And Pelvis With Contrast 84 28 $2,686.00 $2,686.00 $79.45 $2,686.00 $2,360.19 2025-12-11
A0434 HCPCS Specialty Care Transport (sct) 28 28 $2,437.00 $2,437.00 $1,705.90 $2,437.00 $2,315.15 2025-12-11
73723 HCPCS MRI Scan Of Leg Joint Before And After Contrast 112 28 $2,309.00 $2,309.00 $1,616.30 $2,309.00 $2,193.55 2025-12-11
73720 HCPCS MRI Scan Of Leg Before And After Contrast 112 28 $2,309.00 $2,309.00 $1,616.30 $2,309.00 $2,193.55 2025-12-11
J7307 HCPCS Etonogestrel (contraceptive) Implant System, Including Implant And Supplies 28 28 $2,221.00 $2,221.00 $1,554.70 $2,221.00 $2,109.95 2025-12-11
72149 HCPCS MRI Scan Of Lower Spinal Canal With Contrast 56 28 $2,210.00 $2,210.00 $1,547.00 $2,210.00 $2,099.50 2025-12-11
J7298 HCPCS Levonorgestrel-releasing Intrauterine Contraceptive System (mirena), 52 Mg 28 28 $2,056.00 $2,056.00 $1,439.20 $2,056.00 $1,953.20 2025-12-11
74178 HCPCS CT Scan Of Abdomen And Pelvis Before And After Contrast 84 28 $2,210.00 $2,210.00 $87.12 $2,210.00 $1,941.93 2025-12-11
70498 HCPCS CT Scan Of Blood Vessels Of Neck With Contrast 84 28 $2,122.00 $2,122.00 $76.08 $2,122.00 $1,864.60 2025-12-11
J7296 HCPCS Levonorgestrel-releasing Intrauterine Contraceptive System, (kyleena), 19.5 Mg 28 28 $1,960.00 $1,960.00 $1,372.00 $1,960.00 $1,862.00 2025-12-11
74160 HCPCS CT Scan Of Abdomen With Contrast 84 28 $2,090.00 $2,090.00 $55.52 $2,090.00 $1,836.49 2025-12-11
A0426 HCPCS Ambulance Service, Advanced Life Support, Non-emergency Transport, Level 1 (als … 28 28 $1,899.00 $1,899.00 $1,329.30 $1,899.00 $1,804.05 2025-12-11
73223 HCPCS MRI Scan Of Arm Joint Before And After Contrast 112 28 $1,893.00 $1,893.00 $1,325.10 $1,893.00 $1,798.35 2025-12-11
70548 HCPCS MRI Scan Of Blood Vessels Of Neck With Contrast 28 28 $1,889.00 $1,889.00 $1,322.30 $1,889.00 $1,794.55 2025-12-11
74176 HCPCS CT Scan Of Abdomen And Pelvis Without Contrast 84 28 $2,024.00 $2,024.00 $75.77 $2,024.00 $1,778.49 2025-12-11
70551 HCPCS MRI Scan Of Brain Without Contrast 56 28 $1,815.00 $1,815.00 $1,270.50 $1,815.00 $1,724.25 2025-12-11
72195 HCPCS MRI Scan Of Pelvis Without Contrast 56 28 $1,806.00 $1,806.00 $1,264.20 $1,806.00 $1,715.70 2025-12-11
72148 HCPCS MRI Scan Of Lower Spinal Canal Without Contrast 56 28 $1,753.00 $1,753.00 $1,227.10 $1,753.00 $1,665.35 2025-12-11
J7325 HCPCS Hyaluronan Or Derivative, Synvisc Or Synvisc-one, For Intra-articular Injection,… 28 28 $1,735.00 $1,735.00 $1,214.50 $1,735.00 $1,648.25 2025-12-11
72146 HCPCS MRI Scan Of Middle Spinal Canal Without Contrast 56 28 $1,733.00 $1,733.00 $1,213.10 $1,733.00 $1,646.35 2025-12-11
86711 HCPCS Analysis For Antibody To John Cunningham Virus 28 28 $1,718.00 $1,718.00 $1,202.60 $1,718.00 $1,632.10 2025-12-11
72141 HCPCS MRI Scan Of Upper Spinal Canal Without Contrast 56 28 $1,717.00 $1,717.00 $1,201.90 $1,717.00 $1,631.15 2025-12-11
74170 HCPCS CT Scan Of Abdomen Before And After Contrast 94 28 $1,907.00 $1,907.00 $61.05 $1,907.00 $1,620.95 2025-12-11
90380 HCPCS Respiratory Syncytial Virus Antibody, 0.5 Ml Dosage For Injection Into Muscle 28 28 $1,621.00 $1,621.00 $1,134.70 $1,621.00 $1,539.95 2025-12-11
90381 HCPCS Respiratory Syncytial Virus Antibody, 1.0 Ml Dosage For Injection Into Muscle 28 28 $1,621.00 $1,621.00 $1,134.70 $1,621.00 $1,539.95 2025-12-11
71275 HCPCS CT Scan Of Blood Vessels Of Chest With Contrast 57 28 $2,146.00 $2,146.00 $79.14 $2,146.00 $1,502.20 2025-12-11
J0248 HCPCS Injection, Remdesivir, 1 Mg 28 28 $1,578.00 $1,578.00 $1,104.60 $1,578.00 $1,499.10 2025-12-11
73221 HCPCS MRI Scan Of Arm Joint Without Contrast 112 28 $1,577.00 $1,577.00 $1,103.90 $1,577.00 $1,498.15 2025-12-11
73222 HCPCS MRI Scan Of Arm Joint With Contrast 112 28 $1,577.00 $1,577.00 $1,103.90 $1,577.00 $1,498.15 2025-12-11
11012 HCPCS Removal Of Foreign Material From Skin, Tissue, Muscle, And Bone At Open Broken A… 56 28 $1,813.50 $1,813.50 $402.43 $2,170.00 $1,466.14 2025-12-11
81222 HCPCS Gene Analysis (cystic Fibrosis Transmembrane Conductance Regular) Duplication Or… 28 28 $1,520.00 $1,520.00 $1,064.00 $1,520.00 $1,444.00 2025-12-11
74174 HCPCS CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 84 28 $1,622.00 $1,622.00 $95.10 $1,622.00 $1,425.25 2025-12-11
93306 HCPCS Ultrasound Of Heart With Color-depicted Blood Flow, Rate, Direction And Valve Fu… 28 28 $1,485.00 $1,485.00 $1,039.50 $1,485.00 $1,410.75 2025-12-11
C8929 HCPCS Transthoracic Echocardiography With Contrast, Or Without Contrast Followed By Wi… 28 28 $1,485.00 $1,485.00 $1,039.50 $1,485.00 $1,410.75 2025-12-11
70544 HCPCS MRI Scan Of Blood Vessels Of Head Without Contrast 28 28 $1,469.00 $1,469.00 $1,028.30 $1,469.00 $1,395.55 2025-12-11
73718 HCPCS MRI Scan Of Leg Without Contrast 112 28 $1,478.00 $1,478.00 $991.90 $1,539.00 $1,393.96 2025-12-11
24605 HCPCS Repair Of Dislocated Elbow Under Anesthesia 56 28 $1,540.50 $1,540.50 $478.23 $1,523.87 $1,362.88 2025-12-11
73721 HCPCS MRI Scan Of Leg Joint Without Contrast 112 28 $1,417.00 $1,417.00 $991.90 $1,417.00 $1,346.15 2025-12-11
74181 HCPCS MRI Scan Of Abdomen Without Contrast 56 28 $1,387.00 $1,387.00 $970.90 $1,387.00 $1,317.65 2025-12-11
P9010 HCPCS Blood (whole), For Transfusion, Per Unit 28 28 $1,378.00 $1,378.00 $964.60 $1,378.00 $1,309.10 2025-12-11
27266 HCPCS Closed Treatment Of Dislocated Hip Prosthesis Under Anesthesia 56 28 $1,574.00 $1,574.00 $576.91 $1,801.00 $1,306.59 2025-12-11
72125 HCPCS CT Scan Of Upper Spine Without Contrast 84 28 $1,384.00 $1,384.00 $43.56 $1,384.00 $1,216.12 2025-12-11
73218 HCPCS MRI Scan Of Arm Without Contrast 140 28 $1,278.00 $1,278.00 $894.60 $1,278.00 $1,214.10 2025-12-11
71271 HCPCS Low Dose CT Scan Of Chest For Lung Cancer Screening 28 28 $1,252.00 $1,252.00 $876.40 $1,252.00 $1,189.40 2025-12-11
74150 HCPCS CT Scan Of Abdomen Without Contrast 84 28 $1,290.00 $1,290.00 $51.84 $1,290.00 $1,133.53 2025-12-11
81240 HCPCS Gene Analysis (prothrombin, Coagulation Factor Ii) A Variant 28 28 $1,192.00 $1,192.00 $834.40 $1,192.00 $1,132.40 2025-12-11
74175 HCPCS CT Scan Of Blood Vessels Of Abdomen With Contrast 84 28 $1,266.00 $1,266.00 $78.84 $1,266.00 $1,112.43 2025-12-11
23655 HCPCS Closed Treatment Of Dislocated Shoulder With Manipulation Under Anesthesia 56 28 $1,361.00 $1,361.00 $409.79 $1,970.00 $1,099.29 2025-12-11
75635 HCPCS CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast 56 28 $1,435.00 $1,435.00 $102.77 $2,283.00 $1,083.74 2025-12-11
Q5110 HCPCS Injection, Filgrastim-aafi, Biosimilar, (nivestym), 1 Microgram 28 28 $1,125.00 $1,125.00 $787.50 $1,125.00 $1,068.75 2025-12-11
A0427 HCPCS Ambulance Service, Advanced Life Support, Emergency Transport, Level 1 (als 1 - … 28 28 $1,112.00 $1,112.00 $778.40 $1,112.00 $1,056.40 2025-12-11
73206 HCPCS CT Scan Of Blood Vessels Of Arm With Contrast 112 28 $1,411.00 $1,411.00 $77.92 $2,381.00 $1,047.24 2025-12-11
49405 HCPCS Drainage Of Fluid Collection By Tube Through Skin Using Imaging Guidance 56 28 $1,384.00 $1,384.00 $184.74 $2,197.00 $1,045.88 2025-12-11
49406 HCPCS Drainage Of Fluid Collection Of Abdominal Cavity By Tube Using Imaging Guidance 56 28 $1,383.50 $1,383.50 $184.41 $2,197.00 $1,045.40 2025-12-11
25605 HCPCS Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist Wit… 56 28 $1,088.50 $1,088.50 $514.38 $1,507.00 $1,041.83 2025-12-11
27752 HCPCS Closed Treatment Of Middle Part Of Broken Shin Bone With Manipulation 56 28 $1,258.00 $1,258.00 $490.76 $1,507.00 $1,018.21 2025-12-11
20103 HCPCS Exploration Of Wound Of Arm Or Leg 56 28 $1,268.50 $1,268.50 $336.34 $1,575.00 $1,017.82 2025-12-11
99291 HCPCS Critical Care, First 30-74 Minutes 56 28 $1,347.00 $1,347.00 $205.41 $2,268.00 $1,000.41 2025-12-11
25565 HCPCS Closed Treatment Of Broken Midpart Of Both Forearm Bones With Manipulation 56 28 $1,235.00 $1,235.00 $467.54 $1,507.00 $994.99 2025-12-11
27818 HCPCS Closed Treatment Of 3 Broken Lower Leg Bones At Ankle With Manipulation 56 28 $1,206.50 $1,206.50 $443.62 $1,507.00 $971.07 2025-12-11
87507 HCPCS Detection Test By Nucleic Acid For Digestive Tract Pathogen, Multiple Types Or S… 84 28 $1,010.00 $1,010.00 $587.30 $1,126.00 $958.30 2025-12-11
70496 HCPCS CT Scan Of Blood Vessels Of Head With Contrast 56 28 $1,279.00 $1,279.00 $76.08 $2,126.00 $953.62 2025-12-11
32550 HCPCS Insertion Of Indwelling Tube For Drainage Of Lung Fluid 56 28 $1,244.00 $1,244.00 $194.36 $1,884.00 $952.34 2025-12-11
24675 HCPCS Closed Treatment Of Broken Forearm Bone On Small Finger Side At Elbow With Manip… 56 28 $1,185.00 $1,185.00 $421.42 $1,507.00 $948.87 2025-12-11
94002 HCPCS Initial Hospital Inpatient Or Observation Ventilation Assistance And Management 28 28 $932.00 $932.00 $652.40 $932.00 $885.40 2025-12-11
8327161_1 CDM Combivent Respimat 20-100 Mcg 28 28 $916.00 $916.00 $641.20 $916.00 $870.20 2025-12-11
36556 HCPCS Insertion Of Non-tunneled Central Venous Tube For Infusion (5 Years Or Older) 50 28 $1,027.00 $1,027.00 $80.39 $1,027.00 $847.28 2025-12-11
72130 HCPCS CT Scan Of Middle Spine Before And After Contrast 56 28 $1,145.50 $1,145.50 $55.22 $1,979.00 $843.97 2025-12-11
70492 HCPCS CT Scan Of Soft Tissue Of Neck Before And After Contrast 56 28 $1,069.00 $1,069.00 $70.86 $1,781.00 $796.50 2025-12-11
73702 HCPCS CT Scan Of Leg Before And After Contrast 112 28 $1,080.00 $1,080.00 $52.76 $1,861.00 $796.37 2025-12-11
70491 HCPCS CT Scan Of Soft Tissue Of Neck With Contrast 56 28 $1,054.00 $1,054.00 $60.13 $1,767.00 $783.84 2025-12-11
36430 HCPCS Transfusion Of Blood Or Blood Products 28 28 $811.00 $811.00 $567.70 $811.00 $770.45 2025-12-11
93976 HCPCS Ultrasound Of Abdomen And Pelvis Artery And Vein Blood Flow 84 28 $865.00 $865.00 $36.20 $865.00 $760.08 2025-12-11
8338264_1 CDM Symbicort 160-4.5 Mcg Inhaler 28 28 $789.00 $789.00 $552.30 $789.00 $749.55 2025-12-11
Q5125 HCPCS Injection, Filgrastim-ayow, Biosimilar, (releuko), 1 Microgram 28 28 $784.00 $784.00 $548.80 $784.00 $744.80 2025-12-11
73706 HCPCS CT Scan Of Blood Vessels Of Lower Leg With Contrast 112 28 $971.00 $971.00 $81.60 $1,476.00 $742.61 2025-12-11
J1610 HCPCS Injection, Glucagon Hydrochloride, Per 1 Mg 28 28 $775.00 $775.00 $542.50 $775.00 $736.25 2025-12-11
72129 HCPCS CT Scan Of Middle Spine With Contrast 56 28 $981.00 $981.00 $53.07 $1,663.00 $727.06 2025-12-11
72132 HCPCS CT Scan Of Lower Spine With Contrast 56 28 $977.50 $977.50 $53.07 $1,656.00 $724.62 2025-12-11
72126 HCPCS CT Scan Of Upper Spine With Contrast 56 28 $977.50 $977.50 $53.08 $1,656.00 $724.62 2025-12-11
71270 HCPCS CT Scan Of Chest Before And After Contrast 56 28 $966.50 $966.50 $56.89 $1,593.00 $722.45 2025-12-11
70470 HCPCS CT Scan Of Head Or Brain Before And After Contrast 56 28 $943.50 $943.50 $55.22 $1,573.00 $702.84 2025-12-11
81514 HCPCS Measurement Of DNA Of Bacteria In Vaginal Fluid Specimen 28 28 $735.00 $735.00 $514.50 $735.00 $698.25 2025-12-11
32551 HCPCS Removal Of Fluid From Between Lung And Chest Cavity 56 28 $935.50 $935.50 $148.74 $1,562.00 $696.57 2025-12-11
10121 HCPCS Removal Of Foreign Body From Tissue, Accessed Beneath The Skin, Complex 56 28 $913.00 $913.00 $179.25 $1,456.00 $689.05 2025-12-11
70490 HCPCS CT Scan Of Soft Tissue Of Neck Without Contrast 56 28 $909.00 $909.00 $55.83 $1,503.00 $678.83 2025-12-11
81207 HCPCS Translocation Analysis (bcr/abl1) Minor Breakpoint 28 28 $711.00 $711.00 $497.70 $711.00 $675.45 2025-12-11
71260 HCPCS CT Scan Of Chest With Contrast 56 28 $898.50 $898.50 $53.01 $1,490.00 $670.39 2025-12-11
70482 HCPCS CT Scan Of Cranial Cavity Before And After Contrast 56 28 $855.00 $855.00 $54.91 $1,355.00 $646.42 2025-12-11
P9040 HCPCS Red Blood Cells, Leukocytes Reduced, Irradiated, Each Unit 28 28 $665.00 $665.00 $465.50 $665.00 $631.75 2025-12-11
8028192_1 CDM Room & Board - Other - Sterile Environment 25 25 $645.00 $645.00 $483.75 $645.00 $625.65 2025-12-11
8028228_1 CDM Room & Board - Other - Sterile Environment 25 25 $645.00 $645.00 $483.75 $645.00 $625.65 2025-12-11
99285 HCPCS Emergency Department Visit With High Level Of Medical Decision Making 56 28 $806.00 $806.00 $168.54 $1,223.00 $616.72 2025-12-11
8318711_1 CDM Santyl Ointment 28 28 $645.00 $645.00 $451.50 $645.00 $612.75 2025-12-11
87154 HCPCS Amplifed Nucleic Acid Probe Typing Of Disease Agent In Blood Culture Specimen 28 28 $643.00 $643.00 $450.10 $643.00 $610.85 2025-12-11
8337390_1 CDM Tresiba Flextouch 200 Unit/ml 28 28 $638.00 $638.00 $446.60 $638.00 $606.10 2025-12-11
72131 HCPCS CT Scan Of Lower Spine Without Contrast 56 28 $815.50 $815.50 $43.56 $1,384.00 $604.19 2025-12-11
73701 HCPCS CT Scan Of Leg With Contrast Material 112 28 $796.00 $796.00 $50.31 $1,305.00 $595.94 2025-12-11
26775 HCPCS Closed Treatment Of Dislocated Finger Joint With Manipulation Under Anesthesia 56 28 $885.50 $885.50 $361.11 $1,113.56 $591.85 2025-12-11
10140 HCPCS Drainage Of Blood Or Fluid Accumulation 56 28 $784.50 $784.50 $116.30 $1,345.00 $587.05 2025-12-11
72128 HCPCS CT Scan Of Middle Spine Without Contrast 56 28 $789.50 $789.50 $43.56 $1,332.00 $586.00 2025-12-11
73201 HCPCS CT Scan Of Arm With Contrast 112 28 $771.00 $771.00 $50.31 $1,255.00 $578.44 2025-12-11
86366 HCPCS Test For Muscle-specific Kinase Antibody 28 28 $598.00 $598.00 $418.60 $598.00 $568.10 2025-12-11
71250 HCPCS CT Scan Of Chest Without Contrast 56 28 $752.00 $752.00 $49.13 $1,252.00 $560.42 2025-12-11
94003 HCPCS Follow-up Inpatient Or Observation Ventilation Assistance And Management 28 28 $585.00 $585.00 $409.50 $585.00 $555.75 2025-12-11
G0379 HCPCS Direct Admission Of Patient For Hospital Observation Care 28 28 $575.00 $575.00 $402.50 $575.00 $546.25 2025-12-11
12020 HCPCS Simple Closure Of Surface Wound Reopening 94 28 $610.00 $610.00 $184.72 $765.00 $545.15 2025-12-11
81256 HCPCS Gene Analysis (hemochromatosis) Common Variants 28 28 $572.00 $572.00 $400.40 $572.00 $543.40 2025-12-11
P9021 HCPCS Red Blood Cells, Each Unit 28 28 $570.00 $570.00 $399.00 $570.00 $541.50 2025-12-11
73700 HCPCS CT Scan Of Leg Without Contrast 112 28 $723.50 $723.50 $43.56 $1,200.00 $539.79 2025-12-11
94660 HCPCS Therapy Procedure Using A Positive Pressure Ventilator 28 28 $554.00 $554.00 $387.80 $554.00 $526.30 2025-12-11
92950 HCPCS Manual Attempt To Restore Blood Circulation And Breathing 28 28 $546.00 $546.00 $382.20 $546.00 $518.70 2025-12-11
7780189_1 CDM Surgicel Fibrillar 2x4in__twn 28 28 $545.00 $545.00 $381.50 $545.00 $517.75 2025-12-11
81292 HCPCS Gene Analysis (mutL Homolog 1, Colon Cancer, Nonpolyposis Type 2) Full Sequence … 28 28 $540.00 $540.00 $378.00 $540.00 $513.00 2025-12-11
70450 HCPCS CT Scan Head Or Brain Without Contrast 56 28 $688.50 $688.50 $37.12 $1,169.00 $510.03 2025-12-11
70487 HCPCS CT Scan Of Face With Contrast 56 28 $661.50 $661.50 $49.08 $1,046.00 $500.45 2025-12-11
13121 HCPCS Complicated Repair Of Wound Of Scalp, Arms, Or Legs, 2.6-7.5 Cm 56 28 $562.50 $562.50 $250.34 $610.00 $499.55 2025-12-11
P9051 HCPCS Whole Blood Or Red Blood Cells, Leukocytes Reduced, Cmv-negative, Each Unit 28 28 $520.00 $520.00 $364.00 $520.00 $494.00 2025-12-11
93975 HCPCS Complete Ultrasound Of Abdomen And Pelvis Artery And Vein Blood Flow 56 28 $645.50 $645.50 $52.34 $1,004.00 $490.59 2025-12-11
73200 HCPCS CT Scan Of Arm Without Contrast 168 28 $652.00 $652.00 $43.56 $1,057.00 $489.75 2025-12-11
81298 HCPCS Gene Analysis (mutS Homolog 6 [e Coli]) Full Sequence Analysis 28 28 $513.00 $513.00 $359.10 $513.00 $487.35 2025-12-11
92960 HCPCS External Shock To Heart To Regulate Heart Beat 56 28 $633.50 $633.50 $103.72 $951.00 $486.11 2025-12-11
12035 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 12.6-20.… 56 28 $559.50 $559.50 $235.68 $635.00 $470.42 2025-12-11
99284 HCPCS Emergency Department Visit With Moderate Level Of Medical Decision Making 56 28 $608.00 $608.00 $116.24 $951.00 $461.38 2025-12-11
C1751 HCPCS Catheter, Infusion, Inserted Peripherally, Centrally Or Midline (other Than Hemo… 28 28 $473.00 $473.00 $331.10 $473.00 $449.35 2025-12-11
0027U OTHER Gene Analysis (Janus Kinase 2) Of Targeted Sequence Exons 12-15 28 28 $471.00 $471.00 $329.70 $471.00 $447.45 2025-12-11
24600 HCPCS Repair Of Dislocated Elbow 56 28 $566.50 $566.50 $312.90 $696.12 $447.00 2025-12-11
6984200_1 CDM Set Needle 15gx25mm Ez-io (__stw 28 28 $464.00 $464.00 $324.80 $464.00 $440.80 2025-12-11
33016 HCPCS Drainage Of Heart Sac Using Imaging Guidance 49 28 $482.00 $482.00 $222.18 $482.00 $438.90 2025-12-11
J3489 HCPCS Injection, Zoledronic Acid, 1 Mg 28 28 $462.00 $462.00 $323.40 $462.00 $438.90 2025-12-11
87902 HCPCS Analysis Test By Nucleic Acid For Hepatitis C Virus 28 28 $459.00 $459.00 $321.30 $459.00 $436.05 2025-12-11
90678 HCPCS Respiratory Syncytial Virus Vaccine, preF, Subunit, Bivalent, For Intramuscular … 28 28 $457.00 $457.00 $319.90 $457.00 $434.15 2025-12-11
70486 HCPCS CT Scan Of Face Without Contrast 56 28 $577.50 $577.50 $37.43 $945.00 $432.60 2025-12-11
86363 HCPCS Flow Cytometry Detection Of Myelin Oligodendrocyte Glycoprotein (mog-igg1) Antib… 28 28 $455.00 $455.00 $318.50 $455.00 $432.25 2025-12-11
86053 HCPCS Flow Cytometry Detection Of Aquaporin-4 (neuromyelitis Optica [nmo]) Antibody 28 28 $455.00 $455.00 $318.50 $455.00 $432.25 2025-12-11
92523 HCPCS Evaluation Of Speech Sound Production With Evaluation Of Language Comprehension … 28 28 $453.00 $453.00 $317.10 $453.00 $430.35 2025-12-11
93970 HCPCS Ultrasound Study Of Arm Or Leg Veins With Compression And Maneuvers 84 28 $486.00 $486.00 $31.02 $486.00 $427.05 2025-12-11
64447 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Thigh Nerve (femoral Nerve) 50 28 $517.00 $517.00 $61.37 $517.00 $426.52 2025-12-11
11760 HCPCS Repair Of Fingernail Or Toenail Bed 56 28 $542.50 $542.50 $106.62 $761.00 $423.49 2025-12-11
85598 HCPCS Phospholipid Test 28 28 $432.00 $432.00 $302.40 $432.00 $410.40 2025-12-11
82139 HCPCS Amino Acid Level, 6 Or More Amino Acids, Quantitative, Each Specimen 28 28 $429.00 $429.00 $300.30 $429.00 $407.55 2025-12-11
26755 HCPCS Closed Treatment Of Broken End Of Finger Or Thumb With Manipulation 56 28 $488.00 $488.00 $281.93 $563.86 $405.00 2025-12-11
76830 HCPCS Ultrasound Scan Of Uterus, Ovaries, Tubes, Cervix And Pelvic Area Through Vagina 84 28 $460.00 $460.00 $31.68 $460.00 $404.20 2025-12-11
93971 HCPCS Ultrasound Study Of One Arm Or Leg Veins With Compression And Maneuvers 168 28 $452.00 $452.00 $20.03 $452.00 $397.17 2025-12-11
87505 HCPCS Detection Test By Nucleic Acid For Digestive Tract Pathogen, Multiple Types Or S… 28 28 $407.00 $407.00 $284.90 $407.00 $386.65 2025-12-11
23650 HCPCS Closed Treatment Of Dislocated Shoulder With Manipulation 56 28 $462.50 $462.50 $269.50 $614.20 $385.00 2025-12-11
7724927_1 CDM Mask S Comfortgel Blue W/head__twn 28 28 $405.00 $405.00 $283.50 $405.00 $384.75 2025-12-11
7755816_1 CDM Mask M Comfortgel Blue W/head__twn 28 28 $404.00 $404.00 $282.80 $404.00 $383.80 2025-12-11
A0429 HCPCS Ambulance Service, Basic Life Support, Emergency Transport (bls-emergency) 28 28 $403.00 $403.00 $282.10 $403.00 $382.85 2025-12-11
76870 HCPCS Ultrasound Scan Of Scrotum 56 28 $512.00 $512.00 $29.09 $865.00 $379.87 2025-12-11
36680 HCPCS Insertion Of Needle For Infusion Into Bone 28 28 $397.00 $397.00 $277.90 $397.00 $377.15 2025-12-11
87522 HCPCS Detection Test By Nucleic Acid For Hepatitis C Virus, Quantification 28 28 $396.00 $396.00 $277.20 $396.00 $376.20 2025-12-11
80306 HCPCS Testing For Presence Of Drug, Read By Instrument Assisted Observation 28 28 $394.00 $394.00 $275.80 $394.00 $374.30 2025-12-11
12034 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 7.6-12.5… 56 28 $402.00 $402.00 $199.95 $399.90 $364.62 2025-12-11
93880 HCPCS Ultrasound Of Both Sides Of Head And Neck Blood Flow 56 28 $480.00 $480.00 $36.19 $762.00 $362.73 2025-12-11
90710 HCPCS Measles, Mumps, Rubella, And Varicella Vaccine 28 28 $381.00 $381.00 $266.70 $381.00 $361.95 2025-12-11
49083 HCPCS Drainage Of Fluid From Abdominal Cavity Using Imaging Guidance 56 28 $453.00 $453.00 $101.75 $593.00 $359.36 2025-12-11
99236 HCPCS Hospital Inpatient Or Observation Care With Admission And Discharge On The Same … 28 28 $417.00 $417.00 $199.34 $404.49 $359.18 2025-12-11
92610 HCPCS Evaluation Of Swallowing Function 28 28 $375.00 $375.00 $262.50 $375.00 $356.25 2025-12-11
12042 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 2.6-7.5 Cm 60 28 $392.00 $392.00 $190.93 $392.00 $352.80 2025-12-11
12032 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 2.6-7.5 … 56 28 $386.50 $386.50 $185.79 $392.00 $350.33 2025-12-11
10061 HCPCS Complicated Or Multiple Drainage Of Skin Abscess 56 28 $381.00 $381.00 $179.63 $392.00 $349.68 2025-12-11
A0428 HCPCS Ambulance Service, Basic Life Support, Non-emergency Transport, (bls) 28 28 $368.00 $368.00 $257.60 $368.00 $349.60 2025-12-11
11982 HCPCS Removal Of Drug Delivery Implant From Tissue 94 28 $397.00 $397.00 $70.35 $444.00 $348.85 2025-12-11
87536 HCPCS Detection Test By Nucleic Acid For HIV-1 Virus, Quantification 28 28 $365.00 $365.00 $255.50 $365.00 $346.75 2025-12-11
85130 HCPCS Assessment Of Blood Clotting Function 28 28 $365.00 $365.00 $255.50 $365.00 $346.75 2025-12-11
31500 HCPCS Emergent Insertion Of Breathing Tube Into Windpipe Using An Endoscope 50 28 $386.00 $386.00 $136.49 $386.00 $339.12 2025-12-11
72192 HCPCS CT Scan Of Pelvis Without Contrast 122 28 $354.00 $354.00 $47.24 $2,210.00 $336.30 2025-12-11
99223 HCPCS Initial Hospital Inpatient Or Observation Care With High Level Of Medical Decisi… 28 28 $363.00 $363.00 $167.03 $352.11 $333.85 2025-12-11
J2002 HCPCS Injection, Lidocaine Hcl In 5% Dextrose, 1 Mg 56 28 $462.00 $462.00 $47.60 $856.00 $333.60 2025-12-11
96365 HCPCS Infusion Into A Vein For Therapy, Prevention, Or Diagnosis, 1 Hour Or Less 56 28 $349.50 $349.50 $244.30 $350.00 $332.50 2025-12-11
32554 HCPCS Aspiration Of Fluid From Chest Cavity 56 28 $440.50 $440.50 $84.27 $706.00 $331.98 2025-12-11
82088 HCPCS Aldosterone Hormone Level 28 28 $348.00 $348.00 $243.60 $348.00 $330.60 2025-12-11
93930 HCPCS Ultrasound Of Arm Arteries Or Artery Grafts 56 28 $431.50 $431.50 $36.18 $663.00 $329.05 2025-12-11
90651 HCPCS Human Papillomavirus Vaccine Types 6, 11, 16, 18, 31, 33, 45, 52, 58, Nonavalent 28 28 $346.00 $346.00 $242.20 $346.00 $328.70 2025-12-11
90677 HCPCS Pneumococcal Conjugate Vaccine, 20 Valent (pcv20), For Intramuscular Use 28 28 $345.00 $345.00 $241.50 $345.00 $327.75 2025-12-11
93925 HCPCS Ultrasound Of Leg Arteries Or Artery Grafts 56 28 $428.50 $428.50 $35.54 $663.00 $326.14 2025-12-11
77066 HCPCS Diagnostic Mammography Of Both Breasts 28 28 $341.00 $341.00 $238.70 $341.00 $323.95 2025-12-11
82542 HCPCS Chemical Analysis Using Chromatography Technique 28 28 $340.00 $340.00 $238.00 $340.00 $323.00 2025-12-11
76801 HCPCS Ultrasound Scan Of Pregnant Uterus (less Than 14 Weeks), Single Or First Fetus 84 28 $365.00 $365.00 $45.26 $365.00 $320.73 2025-12-11
76817 HCPCS Vaginal Ultrasound Of Pregnant Uterus 84 28 $365.00 $365.00 $34.27 $365.00 $320.73 2025-12-11
8928610_1 CDM Sodium Polystyrene Sulf Powder 28 28 $336.00 $336.00 $235.20 $336.00 $319.20 2025-12-11
81270 HCPCS Gene Analysis (Janus Kinase 2) Variant 28 28 $336.00 $336.00 $235.20 $336.00 $319.20 2025-12-11
28665 HCPCS Closed Treatment Of Dislocated Joint In Toe Under Anesthesia 56 28 $351.00 $351.00 $124.09 $366.00 $318.81 2025-12-11
81206 HCPCS Translocation Analysis (bcr/abl1) Major Breakpoint 56 28 $406.50 $406.50 $144.20 $607.00 $315.45 2025-12-11
81596 HCPCS Biochemical Assays For Evaluation Of Chronic Hepatitis C Virus Infection 28 28 $328.00 $328.00 $229.60 $328.00 $311.60 2025-12-11
P9016 HCPCS Red Blood Cells, Leukocytes Reduced, Each Unit 56 28 $364.50 $364.50 $217.00 $419.00 $310.00 2025-12-11
86580 HCPCS Skin Test For Tuberculosis 28 28 $326.00 $326.00 $228.20 $326.00 $309.70 2025-12-11
81241 HCPCS Gene Analysis (coagulation Factor V) Leiden Variant 28 28 $323.00 $323.00 $226.10 $323.00 $306.85 2025-12-11
85306 HCPCS Protein S (clotting Inhibitor) Measurement 56 28 $372.50 $372.50 $196.00 $465.00 $302.75 2025-12-11
82642 HCPCS Measurement Of Dihydrotestosterone 28 28 $318.00 $318.00 $222.60 $318.00 $302.10 2025-12-11
76819 HCPCS Ultrasound Scan Of Fetus 56 28 $392.50 $392.50 $34.92 $589.00 $301.21 2025-12-11
90670 HCPCS Pneumococcal Vaccine, 13-valent 28 28 $317.00 $317.00 $221.90 $317.00 $301.15 2025-12-11
11983 HCPCS Removal With Reinsertion Of Drug Delivery Implant Into Tissue 56 28 $302.50 $302.50 $100.03 $397.00 $299.88 2025-12-11
80055 HCPCS Obstetric Blood Test Panel 28 28 $315.00 $315.00 $220.50 $315.00 $299.25 2025-12-11
12002 HCPCS Simple Repair Of Surface Wound Of Scalp, Neck, Underarms, Trunk, Arms, Or Legs, … 84 28 $312.00 $312.00 $56.77 $360.00 $296.40 2025-12-11
76506 HCPCS Ultrasound Scan Of Brain 56 28 $391.00 $391.00 $29.08 $622.00 $295.30 2025-12-11
70488 HCPCS CT Scan Of Face Before And After Contrast 66 28 $312.00 $312.00 $55.22 $391.00 $294.82 2025-12-11
82805 HCPCS Blood Gases Measurement, With O2 Saturation 28 28 $310.00 $310.00 $217.00 $310.00 $294.50 2025-12-11
82803 HCPCS Blood Gases Measurement 28 28 $310.00 $310.00 $217.00 $310.00 $294.50 2025-12-11
P9058 HCPCS Red Blood Cells, Leukocytes Reduced, Cmv-negative, Irradiated, Each Unit 28 28 $310.00 $310.00 $217.00 $310.00 $294.50 2025-12-11
65220 HCPCS Removal Of Foreign Body In Cornea 56 28 $339.00 $339.00 $39.41 $358.90 $292.60 2025-12-11
81295 HCPCS Gene Analysis (mutS Homolog 2, Colon Cancer, Nonpolyposis Type 1) Full Sequence … 28 28 $306.00 $306.00 $214.20 $306.00 $290.70 2025-12-11
97167 HCPCS Evaluation For Occupational Therapy, Typically 1 Hour 28 28 $306.00 $306.00 $214.20 $306.00 $290.70 2025-12-11
77080 HCPCS Dxa Bone Density Measurement Of Hip, Pelvis, Spine 84 28 $330.00 $330.00 $7.38 $331.00 $290.40 2025-12-11
12041 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 2.5 Cm Or Less 60 28 $392.00 $392.00 $142.13 $392.00 $289.13 2025-12-11
76775 HCPCS Limited Ultrasound Scan Behind Abdominal Cavity 84 28 $329.00 $329.00 $26.50 $329.00 $289.09 2025-12-11
80230 HCPCS Measurement Of Infliximab 28 28 $303.00 $303.00 $212.10 $303.00 $287.85 2025-12-11
84445 HCPCS Thyroid Stimulating Immune Globulins (thyroid Related Protein) Level 28 28 $302.00 $302.00 $211.40 $302.00 $286.90 2025-12-11
93931 HCPCS Ultrasound Of One Arm Arteries Or Artery Grafts 168 28 $381.00 $381.00 $21.97 $639.00 $283.31 2025-12-11
90716 HCPCS Varicella Vaccine 28 28 $298.00 $298.00 $208.60 $298.00 $283.10 2025-12-11
93926 HCPCS Ultrasound Of One Leg Arteries Or Artery Grafts 168 28 $380.00 $380.00 $21.64 $639.00 $282.34 2025-12-11
16020 HCPCS Dressing Change Or Removal Of Burn Tissue, Less Than 5% Of Total Body Surface 94 28 $323.00 $323.00 $54.57 $343.00 $281.01 2025-12-11
99235 HCPCS Hospital Inpatient Or Observation Care With Admission And Discharge On The Same … 28 28 $319.00 $319.00 $152.50 $309.43 $279.38 2025-12-11
99205 HCPCS New Patient Office Or Other Outpatient Visit With A High Level Of Medical Decisi… 80 28 $421.00 $421.00 $117.60 $571.33 $279.32 2025-12-11
J2404 HCPCS Injection, Nicardipine, 0.1 Mg 56 28 $375.50 $375.50 $71.40 $649.00 $278.15 2025-12-11
12015 HCPCS Simple Repair Of Surface Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 7.6… 56 28 $385.00 $385.00 $90.61 $463.66 $277.40 2025-12-11
72194 HCPCS CT Scan Of Pelvis Before And After Contrast 84 28 $299.00 $299.00 $53.07 $1,923.00 $276.58 2025-12-11
12031 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 2.5 Cm O… 56 28 $306.50 $306.50 $147.65 $308.00 $275.85 2025-12-11
99306 HCPCS Initial Nursing Facility Care With High Level Of Medical Decision Making, Per Da… 28 28 $341.00 $341.00 $175.16 $350.32 $275.81 2025-12-11
84307 HCPCS Somatostatin (growth Hormone Inhibitor) Level 28 28 $290.00 $290.00 $203.00 $290.00 $275.50 2025-12-11
99292 HCPCS Critical Care, Each Additional 30 Minutes 56 28 $340.00 $340.00 $102.71 $404.00 $275.26 2025-12-11
81374 HCPCS Hla Class I Typing, Low Resolution One Antigen Equivalent 28 28 $289.00 $289.00 $202.30 $289.00 $274.55 2025-12-11
94762 HCPCS Test To Measure Oxygen Level In Blood Using Ear Or Finger Device Continuously Ov… 29 28 $289.00 $289.00 $202.30 $289.00 $274.55 2025-12-11
76856 HCPCS Complete Ultrasound Scan Of Pelvis 56 28 $358.00 $358.00 $31.35 $545.00 $273.69 2025-12-11
28475 HCPCS Closed Treatment Of Broken Foot With Manipulation 56 28 $468.00 $468.00 $190.40 $644.08 $272.00 2025-12-11
82030 HCPCS Adenosine, 5-monophosphate, Cyclic (cyclic Amp) Level 28 28 $286.00 $286.00 $200.20 $286.00 $271.70 2025-12-11
76776 HCPCS Ultrasound Scan Of Transplanted Kidney 56 28 $353.50 $353.50 $34.58 $533.00 $270.94 2025-12-11
29581 HCPCS Application Of Vein Wound Compression Bandages On Lower Leg, Ankle, And Foot 28 28 $282.00 $282.00 $197.40 $282.00 $267.90 2025-12-11
8028227_1 CDM Room & Board - Semi-private (two Beds) - Other 25 25 $276.00 $276.00 $207.00 $276.00 $267.72 2025-12-11
8028193_1 CDM Room & Board - Other - General Classification 25 25 $276.00 $276.00 $207.00 $276.00 $267.72 2025-12-11
76815 HCPCS Limited Ultrasound Of Pregnant Uterus 84 28 $304.00 $304.00 $29.74 $304.00 $267.12 2025-12-11
85307 HCPCS Activated Protein Resistance Assay 28 28 $280.00 $280.00 $196.00 $280.00 $266.00 2025-12-11
72193 HCPCS CT Scan Of Pelvis With Contrast 84 28 $287.00 $287.00 $50.31 $1,212.00 $265.48 2025-12-11
12005 HCPCS Simple Repair Of Surface Wound Of Scalp, Neck, Underarms, Trunk, Arms, Or Legs, … 56 28 $342.50 $342.50 $90.94 $496.00 $265.26 2025-12-11
82157 HCPCS Androstenedione (hormone) Level 28 28 $279.00 $279.00 $195.30 $279.00 $265.05 2025-12-11
96360 HCPCS Infusion Into A Vein For Hydration, 31-60 Minutes 28 28 $276.00 $276.00 $193.20 $276.00 $262.20 2025-12-11
70480 HCPCS CT Scan Of Cranial Cavity Without Contrast 66 28 $307.00 $307.00 $55.52 $307.00 $261.20 2025-12-11
G0438 HCPCS Annual Wellness Visit; Includes A Personalized Prevention Plan Of Service (pps),… 28 28 $205.00 $205.00 $160.32 $320.64 $255.91 2025-12-11
77065 HCPCS Diagnostic Mammography Of 1 Breast 56 28 $268.00 $268.00 $187.60 $268.00 $254.60 2025-12-11
85301 HCPCS Antithrombin Iii Antigen (clotting Inhibitor) Level 28 28 $268.00 $268.00 $187.60 $268.00 $254.60 2025-12-11
51700 HCPCS Simple Bladder Irrigation And/or Instillation 28 28 $266.00 $266.00 $186.20 $266.00 $252.70 2025-12-11
56405 HCPCS Incision And Drainage Of Abscess Of External Female Genitals 56 28 $282.50 $282.50 $124.34 $307.00 $250.26 2025-12-11
99283 HCPCS Emergency Department Visit With Low Level Of Medical Decision Making 56 28 $329.50 $329.50 $68.14 $520.00 $250.14 2025-12-11
82652 HCPCS Dihydroxyvitamin D, 1, 25 Level 28 28 $263.00 $263.00 $184.10 $263.00 $249.85 2025-12-11
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